Intra-Articular Methylprednisolone Injection for Advanced Osteoarthritis in Geriatric Patient Population
Year 2021,
, 19 - 24, 29.01.2021
Ali Yüce
Niyazi İğde
Tahsin Olgun Bayraktar
Mustafa Yerli
Ali Çağrı Tekin
Mehmet Kürşat Bayraktar
Hakan Gürbüz
Abstract
Background: We aimed to investigate the effect of intra-articular methylprednisolone injection on pain and functional outcomes and the number of outpatient clinic admissions in patients with advanced knee osteoarthritis in the geriatric age group.
Methods: The files of 78 patients over the age of 65 who were administered intra-articular methylprednisolone injection with the diagnosis of primary gonarthrosis between 2018 and 2020 were analyzed retrospectively. Age, gender, and affected side of the patients were recorded. The number of outpatient clinic admissions, VAS and WOMAC scores before and after injection were evaluated statistically.
Results: 18 of the patients were male (24.7%) and 55 were female (75.3%). The mean age was 74.95±7.11 years. WOMAC and VAS score values of the patients at the first and third months were significantly lower than the pre-injection period. The decrease in the number of outpatient visits in the 6-month period after the injection compared to the number of outpatient visits in the 6-month period before the injection was statistically significant. A strong positive correlation was found between the number of outpatient visits before injection and the first VAS score.
Conclusions: In geriatric patients with advanced-stage knee osteoarthritis who do not accept total knee arthroplasty, intraarticular methylprednisolone injection may be a feasible method that reduces pain and the number of outpatient clinic visits in the short term.
References
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Year 2021,
, 19 - 24, 29.01.2021
Ali Yüce
Niyazi İğde
Tahsin Olgun Bayraktar
Mustafa Yerli
Ali Çağrı Tekin
Mehmet Kürşat Bayraktar
Hakan Gürbüz
References
- 1.Çeliker R. Kalça ve diz osteoartriti tedavisinde güncel kılavuzlar. Hacettepe Tıp Dergisi 2008;39(1)::36-44
- 2. Borkar S, Bhise S, Raghute S, Thosar S, Godbole S. Clinical outcome of single intra articular injection of triamcinolone acetonide depot preparation on knee osteoarthritis. Int J Orthop Sci 2018; 4(4): 161-3
- 3. Bayrak A, Bayrak SK, Duramaz A, Sahan C, Büyükhatipoğlu A, Aslantaş FÇ. Evre 3-4 Gonartrozlu Hastalarda Diz İçi Steroid Enjeksiyonun Etkinliği. Bakırköy Tıp Dergisi 2018;14:372-76
- 4. Desai M, Bentley A, Keck WA, Haag T, Taylor RS, Dakin H. Cooled radiofrequency ablation of the genicular nerves for chronic pain due to osteoarthritis of the knee: a costeffectiveness analysis based on trial data. BMC Musculoskelet Disord 2019; 20:302
- 5. Keser S, Bayar A, Tuncay İ, Ege A, Demirel N. Osteoartritli Dizlerde İntraartiküler Hyaluronik Asit Enjeksiyon Sonuçları. Romatizma 2004;19(3):173-7
- 6. Khan M, Bhandari M. Cochrane in CORR®: Intra-articular Corticosteroid For Knee Osteoarthritis. Clin Orthop Relat Res 2018; 476:1391-2
- 7. McAlindon TE, LaValley MP, Harvey WF, Price LL, Driban JB, Zhang M, Ward RJ. Effect of Intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: A randomized clinical trial. Jama. 2017; 317:1967–75
- 8. Issın A, Koçkara N, Çamurcu İY. Comparison of efficacy of intraarticular polyacrylamide hydrogel and methylprednisolone acetate in patients with knee osteoarthritis. Cukurova Med J 2018;43(1):124-128
- 9. Kellgren JH, Lawerence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957;16:494-502
- 10. Downie WW, Leatham PA, Rhind VM, Pickup ME, Wright V. The visual analogue scale in the assessment of grip strength. Ann Rheum Dis 1978; 37:382-4
- 11. Collins NJ, Misra D, Felson DT, Crossley KM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS),
- 11......Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res 2011;63(11):208-28
- 12. Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME, et al. Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res 2013;65:703-11
- 13. Uğur M, Tuğuç A, Melikoğlu MA, Yıldırım K, Şenel K. Diz dejeneratif osteoartritli hastalarda intraartiküler hyalüronik asit ile intraartiküler metil prednizolon asetatın etkinliklerinin karşılaştırılması. Eurasian J Med 2007;39:185-8
- 14. Arroll B, Goodyear-Smith F. Corticosteroid injections for osteoarthritis of the knee: meta-analysis. BMJ 2004;328:869–70
- 15. Law TY, Nguyen C, Frank RM, Rosas S, McCormick F. Current concepts on the use of corticosteroid injections for knee osteoarthritis. Phys Sportsmed, 2015;43(3):269-73
- 16. London NJ, Miller LE, Block JE. Clinical and economic consequences of the treatment gap in knee osteoarthritis Management. Med Hypotheses 2011;76(6): 887–92
- 17. Sarı S, Özlülerden P, Aydın ON, Turan Y, Kurt İ, Efe U. Kronik diz osteoartritinde geniküler sinirine radyofrekans termokoagülasyonu: Yeni bir alternatif tedavi için bir pilot çalışma. Turk J Phys Med Rehab 2016;62(3):234-9
- 18. Pasquale MK, Louder AM, Cheung RY, Reiners AT, Mardekian J, Sanchez RJ, et al. Healthcare Utilization and Costs of Knee or Hip Replacements versus Pain-Relief Injections. Am Health Drug Benefits 2015; 8(7): 384–94
- 19. Orak MM, Ak D, Midi A, B Laçin B, Purisa S, et al. Sağlıklı sıçanlarda intra-artiküler tenoksikam, diklofenak ve metilprednizolon kullanımının kronik etkilerinin karşılaştırılması. Acta Orthop Traumatol Turc 2015;49(4):438–46